AHRA: Fine-tuning the radiology practice business model

With radiology practices facing increasing competition and an exceedingly difficult market, a laser sharp business plan is now more essential than ever. The AHRA (Association for Medical Imaging Management) fall conference last week provided a process and practice for revising, revamping and revitalizing the business plan.

The two-part session started with an overview of the business plan, including process improvement, business dashboards and activity-based management. Currently, the critical issues are healthcare reform and business uncertainty, explained David J. Waldron, CEO of Traction Business Development. The combination of legislation and regulation will impact the business cycle and could impact imaging utilization, offered Waldron. He predicted likely outcomes are:

Reduced referral volume;

Reduced reimbursement;

Excess diagnostic imaging capacity; and

Increased competition.

Waldron suggested practices consider quality circles characterized by high quality, low cost service and becoming providers of choice for referring practices. The process requires comprehensive soft and hard analyses of patients, physicians and financial data and a comprehensive, consistent commitment on the part of technologists, operations and physicians.

Practice leaders need to focus on their three critical quality circles – technologists imaging patients; physicians reporting and business cycle operating processes – to position the practice to survive the twin threats of reduced volume and reimbursement, offered Waldron in an interview. Additionally, practice leaders need to undertake an analysis of the market to ensure that they have positioned their services to take maximum advantage of the need for imaging in their specific local area. This demographic analysis should be completed by the hospital’s pillar service leaders and its results integrated with those from diagnostic imaging to ensure that diagnostic imaging is both fully aligned with the pillar services and gains maximum "cross sell" benefits.

At the operational level, lean six-sigma and process mapping can be employed to analyze current processes to eliminate redundancy and inefficiency and as a basis for implementing process improvements. Measurement is essential for management, said Waldron.

For example, when Waldron worked with a mid-Atlantic hospital to improve the performance of its appointment scheduling call center they started by identifying available data that weren’t used and then determined how to translate that data into meaningful metrics. Waldron and hospital administrators shared the newly identified metrics, including call time and wait time with schedulers, to help them focus on their primary responsibilities. The outcome was a dramatic improvement in performance, measured by talk time, call waiting time and dropped call rates. This was achieved through re-engineering processes that resulted in an increase from 50 percent to nearly 90 percent in uptime using the same number of staff. “Measuring call center results and mapping and sharing processes provided an easy way to improve customer satisfaction,” explained Waldron.

Marketing for success In the second half of the session, Mike Suddendorf, executive director of Premier Radiology Marketing, explained a seven-step action plan for amping the radiology business plan. The process encourages practices to:

Create a vision;

Create a value proposition;

Define key audiences;

Develop key messages;

Prioritize tactics and establish the budget;

Manage deployment and accountability; and

Measure results, retool and celebrate.

Suddendorf presented two case studies of practices that effectively utilized the process to drive business growth. In the first, a 70-physician imaging practice established and promoted a relationship with the Susan G. Komen Foundation to enhance the practice’s standing as a local leader in breast imaging and increase breast imaging volume.

In the second case study, Suddendorf showcased Riverside Radiology and Interventional Associates in Columbus, Ohio, a practice that adopted the method to better capitalize on its 11 vascular and interventional subspecialists, specifically targeting EndoVenous Laser Treatment (EVLT) procedures.

The practice honed its goals and defined its current state as excess vascular and interventional capacity and with a marketing program focused primarily on physicians and hampered by out-of-date consumer materials. Finally,